Case-based small-group discussions (SGDs) are one of the teaching strategies used in the Department of Medical Physiology of the Pamantasan ng Lungsod ng Maynila College of Medicine. The purpose of this study was to investigate the relationship between the first-year medical students' grades in SGDs and their academic performance measured at the end of each shifting period and the end of the course. All 135 students were assessed and graded during clinical case SGDs. Correlational analyses indicate a significant relationship between the SGD grades and the students' grades in the written examination, shifting period medical physiology grades, and final medical physiology grades. SGDs are linked to improved academic performance, but further studies are needed to investigate other predictors of students' learning in medical physiology.